Tren Tata Laksana Kanker Prostat Lokal Lanjut di Indonesia

GAMPO ALAM IRDAM (Divisi Urologi Departemen Ilmu Bedah Fakultas Kedokteran Universitas Indonesia/Departemen Urologi Rumah Sakit Cipto Mangunkusumo)

Indonesian Journal of Cancer
Vol 9, No 1 (2015): Jan - Mar 2015

ABSTRACTAim: to evaluate treatment trend of stage T3 prostate cancer based on several factors. Methods: a retrospective studywas done on stage T3 prostate cancer patients from year 1995-2013, at two national referral hospitalsin Indonesia.Treatment trends between hormonal therapy and radiotherapy based on year of treatment, PSA level, tumor grade andage groups were evaluated.Results: On 50 patients subjects, 25 (50%), 23 (46%) and 2 (4%) subjects were treated byradiotherapy, hormonal therapy and radical prostatectomy, respectively. Year of treatment were significantly associatedwith treatment selection (p=0.012), after excluding year of treatment 1995-1999 group. Hormonal therapy was preferredon high grade tumor group (53.8%) and more applied for older patients. Treatment trend was not affected by PSA level.Conclusion: Year of treatment were significantly associated with treatment selection of stage T3 prostate cancer.Hormonal therapy was preferred on high grade tumor group and older age groups.Keyword: treatment trend, locally advanced prostate cancer, radiotherapy, hormonal therapyABSTRAKPenelitian ini bertujuan mengevaluasi tren tata laksana kanker prostat stage T3 berdasarkan faktor-faktor yangmemengaruhi. Metode: studi retrospektif tata laksana kanker prostat stage T3 di Rumah Sakit Cipto Mangunkusumodan Rumah Sakit Kanker Dharmais periode 1995-2013. Data tren pemilihan terapi antara radioterapi atau terapihormonal dianalisis berdasarkan kelompok tahun terapi, kadar PSA, grade tumor, dan kelompok usia. Hasil penelitianmenunjukkan dari 50 subjek, 25 (50%), 23 (46%), dan 2 (4%) subjek mendapatkan tata laksana radioterapi, terapihormonal, dan prostatektomi radikal secara berturutan. Perubahan tren pemilihan terapi berdasarkan tahun terapisecara statistik signifikan (p=0,012), dengan mengeksklusikan kelompok periode terapi 1995-1999. Terapi hormonallebih menjadi pilihan untuk kelompok tumor high grade (53,8%) dan lebih sering dipilih seiring bertambahnya usiapasien. Kadar PSA tidak memengaruhi tren pemilihan terapi. Kesimpulan: terdapat perubahan yang bermakna dalampemilihan terapi kanker prostat stage T3 berdasarkan tahun terapi. Terapi hormonal lebih menjadi pilihan pada kasusdengan tumor high grade dan kelompok usia yang semakin tua.Kata Kunci: tren terapi, kanker prostat lokal lanjut, radioterapi, terapi hormonal